Healthcare Provider Details

I. General information

NPI: 1659255008
Provider Name (Legal Business Name): CARMEN MARIE HULL PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 BROWN ST
ANDERSON IN
46016-4216
US

IV. Provider business mailing address

11542 CHARLESTON PKWY
FISHERS IN
46038-1956
US

V. Phone/Fax

Practice location:
  • Phone: 765-393-3891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28244188A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: